Ritopar
Generic Name
Ritodrine Hydrochloride
Manufacturer
ACI Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ritopar 10 mg tablet | ৳ 8.02 | ৳ 80.20 |
Description
Overview of the medicine
Ritodrine is a beta-2 adrenergic agonist used to relax uterine smooth muscle and inhibit uterine contractions in cases of preterm labor. It helps to prolong pregnancy, allowing for more fetal development and administration of corticosteroids for lung maturation.
Uses & Indications
Dosage
Adults
Initially 10 mg orally, 30 minutes before discontinuing IV infusion, then 10 mg every 2 hours for 24 hours, followed by 10-20 mg every 4-6 hours. Max oral dose: 120 mg/day.
Elderly
Not typically used in elderly as preterm labor is specific to younger adults. If used for other beta-agonist effects, adjust cautiously due to potential cardiovascular effects.
Renal_impairment
No specific dosage adjustment guidelines, but caution is advised due to renal excretion.
How to Take
Oral tablets can be taken with or without food. Typically, oral therapy follows successful intravenous therapy or is used for maintenance. Do not crush or chew the tablet.
Mechanism of Action
Ritodrine selectively stimulates beta-2 adrenergic receptors in the uterine smooth muscle. This stimulation activates adenyl cyclase, increasing cyclic AMP (cAMP) levels, which leads to the phosphorylation of proteins that inhibit myosin light-chain kinase. This results in decreased intracellular calcium levels, leading to uterine muscle relaxation and inhibition of contractions.
Pharmacokinetics
Onset
Oral: ~60 minutes.
Excretion
Excreted mainly in the urine, predominantly as inactive conjugates. About 70-90% of a dose is excreted within 24 hours.
Half life
Biphasic elimination, initial half-life ~1.3 hours, terminal half-life ~12-20 hours.
Absorption
Rapidly absorbed after oral administration, bioavailability is about 30%. Peak plasma concentrations achieved within 30-60 minutes.
Metabolism
Primarily metabolized in the liver via conjugation (glucuronidation) and possibly some O-demethylation.
Side Effects
Contraindications
- Known hypersensitivity to ritodrine or other sympathomimetics
- Pre-existing maternal heart disease (e.g., severe heart failure, uncontrolled hypertension)
- Pre-existing pulmonary hypertension
- Hyperthyroidism
- Uncontrolled diabetes mellitus
- Pre-eclampsia/eclampsia
- Intrauterine infection
- Antepartum hemorrhage requiring immediate delivery
- Intrauterine fetal death
- Gestational age <20 weeks or >36 weeks where fetal lung maturity is complete
- Prolapse of the umbilical cord
Drug Interactions
Beta-blockers
Antagonize the effects of ritodrine.
Corticosteroids
Increased risk of pulmonary edema.
Antidiabetic agents
Ritodrine can increase blood glucose levels, requiring adjustment of antidiabetic medication.
Other sympathomimetics
Additive cardiovascular effects.
Anesthetics (halogenated)
Increased risk of cardiac arrhythmias.
Storage
Store below 30°C in a dry place, away from light. Keep out of reach of children.
Overdose
Symptoms of overdose include severe tachycardia, palpitations, arrhythmias, hypotension, hyperglycemia, hypokalemia, and pulmonary edema. Treatment is supportive, including discontinuing the drug, monitoring vital signs, and administering beta-blocking agents if cardiac symptoms are severe.
Pregnancy & Lactation
Pregnancy: Category B (FDA). Used to delay preterm labor. Lactation: Excreted in breast milk in small amounts; caution advised. The decision to breastfeed should consider the benefits to the mother and the potential risks to the infant.
Side Effects
Contraindications
- Known hypersensitivity to ritodrine or other sympathomimetics
- Pre-existing maternal heart disease (e.g., severe heart failure, uncontrolled hypertension)
- Pre-existing pulmonary hypertension
- Hyperthyroidism
- Uncontrolled diabetes mellitus
- Pre-eclampsia/eclampsia
- Intrauterine infection
- Antepartum hemorrhage requiring immediate delivery
- Intrauterine fetal death
- Gestational age <20 weeks or >36 weeks where fetal lung maturity is complete
- Prolapse of the umbilical cord
Drug Interactions
Beta-blockers
Antagonize the effects of ritodrine.
Corticosteroids
Increased risk of pulmonary edema.
Antidiabetic agents
Ritodrine can increase blood glucose levels, requiring adjustment of antidiabetic medication.
Other sympathomimetics
Additive cardiovascular effects.
Anesthetics (halogenated)
Increased risk of cardiac arrhythmias.
Storage
Store below 30°C in a dry place, away from light. Keep out of reach of children.
Overdose
Symptoms of overdose include severe tachycardia, palpitations, arrhythmias, hypotension, hyperglycemia, hypokalemia, and pulmonary edema. Treatment is supportive, including discontinuing the drug, monitoring vital signs, and administering beta-blocking agents if cardiac symptoms are severe.
Pregnancy & Lactation
Pregnancy: Category B (FDA). Used to delay preterm labor. Lactation: Excreted in breast milk in small amounts; caution advised. The decision to breastfeed should consider the benefits to the mother and the potential risks to the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Off-patent
Clinical Trials
Ritodrine has been evaluated in numerous clinical trials for its efficacy and safety in delaying preterm labor. Early trials established its effectiveness compared to placebo, but also highlighted its cardiovascular side effects.
Lab Monitoring
- Monitor maternal heart rate and blood pressure
- Monitor blood glucose levels (especially in diabetics)
- Monitor serum electrolytes (potassium)
- Monitor signs of pulmonary edema (e.g., chest X-ray if indicated)
Doctor Notes
- Careful patient selection is crucial due to potential maternal and fetal adverse effects.
- Monitor maternal cardiovascular status, fluid balance, and blood glucose closely during treatment.
- Educate patients on symptoms requiring immediate medical attention.
Patient Guidelines
- Take exactly as prescribed by your doctor.
- Report any unusual symptoms, especially chest pain, shortness of breath, or severe palpitations.
- Avoid sudden changes in position to prevent dizziness.
- Do not stop taking the medication abruptly without consulting your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double dose to make up for a missed one.
Driving Precautions
May cause dizziness or nervousness; use caution when driving or operating machinery until you know how the drug affects you.
Lifestyle Advice
- Maintain adequate hydration.
- Avoid strenuous activities.
- Follow a balanced diet and monitor blood sugar if diabetic.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.